Uprooting fistula in Mangochi

Florence Kassim, 20, from Mpima Village, Traditional Authority (T/A) Mponda in Mangochi has no kind words for fistula. She lost her marriage because of the disorder.

At 18, she married 22-year-old  Dickson Aufi, from the same village.

A year later, Kassim got pregnant. During childbirth, she had a prolonged labour and she delivered through operation. The prolonged obstructed labour.

“I discovered that I had fistula a year and half after delivery,” she explains.

Obstetric fistula is a medical condition in which a fistula (hole) develops between either the rectum and vagina or between the bladder and vagina after severe or failed childbirth, when adequate medical care is not available.

But this did not go down well with her husband who became angry and unsatisfied with his wife. “My husband got angry with my condition. He even denied staying close to me. When I prepared food for him, he refused to eat,” she said.

According to Kassim, her husband said he could not afford to have a wife who smelled urine. The husband further said it was better to marry another woman.

Today, Kassim’s condition has normalised. She has been repaired and she can manage a smile.

“I can’t express how happy I am to be normal again after being mocked by villagers,” she says.

Kassim is among 57 fistula patients who underwent reconstructive surgery in Mangochi courtesy of African Medical Research Foundation-Health Africa (Amref-Health Africa).

Half of the women who have lived with the medical condition said their marriages collapsed.

Amref-Health Africa is providing fistula surgery services to health facilities which have maternity wards in Mangochi. This is the first project in Malawi for the foundation which is offering similar services in Kenya and Uganda. Amref-Health Africa has partnered with Christian Health Association of Malawi (Cham).

Amref project officer Charles Suya says the organisation chose Mangochi following a survey that was conducted in the district.

“Our survey revealed that there were more maternal deaths in the district. Furthermore, total fertility ratio is high in the district. Currently, it is at 7.2 which means that on average, every woman has seven children. This has contributed to increase in the number of fistula cases” says Suya.

He says the project is making good progress because the communities are cooperative.

“I am very thankful to the chiefs in Mangochi because upon being sensitized on the dangers of keeping fistula a secret, they started forwarding the message to women in their villages. That is why women are still coming to be repaired at out centres,” he says.

Traditional Authority (T/A) Chowe from the district, says he and mhis fellow chiefs are committed to fight against fistula.

“We are the ones who live with people hence we can easily mobilise women who are suffering from fistula to go to the medical people where they are repaired. As chiefs, we will be in the forefront to fight against this disease until the battle is won,” says T/A Chowe.

Amref-Health Africa hires medical personnel from Queen Elizabeth Central Hospital (QECH) and Mangochi District Hospital who carry out the fistula surgeries.

Suya says: “Our vision is for all women to have access to healthcare during pregnancy and childbirth and help to eradicate obstetric fistula. We want to repair about 400 women.”

He adds that the condition is common where the healthcare system functions poorly that women do not have access to quality maternal healthcare.

In her remarks, nurse-midwife technician for Monkey-Bay Community Hospital, Tawonga Kasonde says fistula is an abnormality which needs a holistic approach. She also says victims of fistula are subjected to a barrage of mockery and discrimination.

“Women should take this opportunity that Amref is in Mangochi to fight fistula. They should report to hospital when they show signs and symptoms of fistula so that they can be assisted accordingly and in good time,” says Kasonde.

On his part, Suya says his organisation is also engaging councillors to take part in the fight against the condition.

“Now that councillors are back in communities, we want to engage them in this project by encouraging them to convince people especially women in their wards to report to us when they discover that they have fistula so that we should repair them,” says Suya.